Introduction
Early in breastfeeding, a condition known as hyperlactation results in swollen, leaky breasts that do not noticeably relax after feeding. Painful milk letdowns, acute engorgement, and breast soreness are frequent. Breastfeeding might be challenging if there is an excess of breast milk. Breastfeeding may cause a newborn to choke and cough due to an excessive milk rush. Infants that experience hyperlactation may put on too much weight. Breast discomfort, clogged ducts, and mastitis are just a few nursing issues patients with hyperlactation may experience.
What Is Hyperlactation?
According to international standards, hyperlactation, also known as hypergalactia or oversupply, produces more breast milk than is necessary for healthy newborn (or infant) growth. Since there is no clear definition for this term, recorded cases cover a wide range of excess volumes. A term infant typically eats between 450 and 1,200 mL per day, and production volumes over this point may signify hyperlactation.
What Is Self-Induce Hyperlactation?
By using various methods, many women self-induce hypergalactia. In addition to nursing, pumping increases milk production. Many herbal supplements increase the milk supply, such as saw palmetto, alfalfa, blessed thistle, fenugreek, fennel, goat's rue, and shatavari. Instead of nursing in accordance with infant feeding signals, new mothers are frequently told to breastfeed for 15 to 20 minutes on each breast. This leads some mothers to nurse for longer periods than the baby needs to, raising the prolactin level further.
What Triggers Hyperlactation While Nursing?
There are various reasons for an excessive supply of breast milk, including
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A person's amount of mammary glandular tissue breast.
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Mismanagement of breastfeeding.
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Having enlarged alveoli in the breast
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Medications that boost milk production.
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The extent and regularity of milk emptying.
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Diverse neuroendocrine pathways
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Prolactin levels in the blood are too high (hyperprolactinemia), which promotes milk production.
What Are the Signs and Symptoms of Hyperlactation?
Maternal Symptoms and Signs:
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Persistent breast heaviness.
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More than two cup sizes of excessive breast development during pregnancy.
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Milk leaks.
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Pain in the breasts or nipples.
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Vasospasm.
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Repeatedly blocked ducts.
Infant Symptoms and Signs:
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Symptoms of the digestive system include spitting up, gas, reflux, or explosive green stools.
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Brief feedings.
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Refusal of breasts.
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Need help getting a durable, deep latch.
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Coughing, choking, or unlocking while feeding and fluttering in the breast.
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Squeezing the nipple or areola.
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Unhealthy weight gain.
What Are Ways in Which Mothers Can Prevent Hyperlactation?
Mothers can attempt employing the relaxed physical nursing posture to reduce the flow rate while maintaining a positive direct breastfeeding relationship until the rate of milk production is regulated. Mothers can gently massage their breasts before feedings to increase the milk's fat content. When milk expression is necessary, they should choose hand expression over mechanical expression to avoid clinical concerns about significant foremilk-hindmilk imbalance.
How Can Hyperlactation Be Managed?
It is advised for the mother to lie in the reclining position and consider positioning the infant such that gravity reduces the milk flow. Additionally, give the regular infant burps and let them leave the breast as needed.
Usually, hyperlactation ends after a few weeks. However, the doctor may perform a thyroid examination to rule out potential thyroid-related causes if the issue persists.
Self-Induced and Iatrogenic Hyperlactation:
It can be prevented and treated with behavioral interventions and proactive counseling. Block feeding should be used as the first-line therapy for idiopathic hyperlactation.
Persistent Idiopathic Hyperlactation:
Herbal treatments and prescription drugs may be considered for persistent idiopathic hyperlactation situations that do not react well to block feeding. According to the dyad's unique circumstances, including the number of weeks postpartum, potential drug interactions, adverse drug reactions, patient preferences, and cultural beliefs, second-line, and subsequent therapies should be chosen.
Dopamine Agonists:
Due to the dangers of severe medication side effects and the potential for a total cessation of milk production, dopamine agonists should only be used in the most refractory cases of idiopathic hyperlactation. Dopamine agonists like Bromocriptine or Cabergoline can be used if hyperlactation still occurs despite all other attempts at treatment. In lactating mothers, Cabergoline is chosen over Bromocriptine due to its better side effect profile. A long-acting drug called Cabergoline has a half-life of 68 hours. Starting with a single dose of 0.25 milligrams (mg), repeat this dose if the mother's milk output does not decrease within 72 hours. Increase the dose to 0.5 mg three to five days later if the initial low dose is ineffective. In the absence of Cabergoline, 0.25 mg of Bromocriptine daily for three days may be administered.
Herbs:
A few herbs have been clinically proven to lower milk production. Salvia officinalis, also known as sage, is the most popular plant used to decrease milk supply.
What Are the Problems Associated With Hyperlactation?
Infants may become underweight if their diets are too high in foremilk, which is high in carbohydrates, and too low in hindmilk, which is high in fat. As a result, infants may act uninterested in feedings, struggle to establish a latch and be fussy at the beginning of feedings. Therefore, it is essential to consult a lactation specialist if the mother is hyper-lactating. Until the next full feeding, they might advise breastfeeding on only one side during each nursing session and providing that breast for at least two hours. Then, if the second breast gets too full, one can hand-express it or pump it for a short while.
Conclusion
Breast engorgement, the inability to feed the infant from both breasts at each meal, and a strong let-down reflex are all signs of hypergalactia or hyperlactation in mothers. The infant may latch shallowly due to the heavy let-down reflex, which can cause uncomfortable nipples. Due to inconsistent and inadequate breast emptying, the mother may also experience excessive milk leakage, chronically sore engorged breasts, clogged ducts, and mastitis. Infant symptoms include gasping and choking during the first let-down, gaining too much weight, fussiness at the breast, having too much flatus, and passing explosive, green stools. A foremilk-hindmilk imbalance that causes hypergalactia may cause the infant to drink a large amount of foremilk. Infant feces with blood streaks and mucous have occasionally been linked to a high breast milk intake.
